Religion and Spirituality in Psychiatry

Personality, Spirituality, Religiousness, and the Personality Disorders 183personality and Axis II functioning on religioussentiments.The results indicated that the data had modestfit with Model 1. Interestingly, the pathway fromspirituality to Axis II functioning was nonsignificant.This indicated that Spiritual Transcendencedoes not have any substantive relationship withthis outcome. Thus the observed correlationspresented in Table 13.3 above can be attributedto method artifacts in the data (for example, thereliance on all self-report data and sample specificerror). The results for Model 2 indicated muchbetter fit of the data to the model. The pathwayfrom religious sentiments to Axis II functioningwas significant, indicating that one’s religiousinvolvements do have a significant, uniquecausal impact on characterological impairment.Model 3 had the worst fit of all, indicating thatreligious sentiments being a consequence of one’spersonality and temperamental dysfunctionalityis not very likely. That this pattern of findings wasalso replicated with the SNAP PD scales providesstrong support for the position that individualswho are not actively involved in the religiouspractices of their faith and also are experiencingdistress in their relationship with a transcendentbeing are likely to develop psychologicalinstability.(46) It is important to note that theserelationship problems with the transcendentare not a function of one’s innate interpersonalstyle (qualities of personality), nor a function ofinterpersonal impairment due to the personalitydisorder dynamics. The predictive power of theReligious Sentiments scales was not mediated bythese other related constructs. There appears tobe something unique about the relationship withthe transcendent that affects one’s affective andcognitive processes.The independence of spirituality from Axis IIfunctioning raises the possibility that spiritualitymay serve as an important personologicalresource for treatment of PDs. Spirituality’s lack ofinvolvement in the pathognomonic process suggeststhat these motivations may not be distortedor impaired among individuals with Axis IIissues. In other words, individuals experiencinga personality disorder do not necessarily havean impaired spirituality. Although its expressionmay appear odd or unusual in relation to moretraditional presentations, it nonetheless can providethe individual with an important adaptiveresource. Thus, working with spirituality aroundissues of transcendence may be able to providea more realistically based set of perceptions andbeliefs that can be therapeutically useful.7. THE ROLE OF SPIRITUALITYIN TREATING PERSONALITY DISORDERSThe emphasis of this section will be on how spirituallyrelated constructs can be deployed therapeuticallyto provide adaptive skills and potentialself-transformation. How this is accomplished varieswidely, from using more broadly defined meditativeand mindfulness techniques to promoteself-awareness, (51) to applying techniques andactivities that will directly access existential andspiritual questions (for example, past life regression,chanting, and bibliotherapy), (52) to incorporatingspecific scriptural passages that both guidethe therapy and provide relevant reflections thatspeak to core issues of spirituality.(38, 53) Findingways to spiritually intervene is a young area, andthere are a growing number of treatment-relatedtexts now appearing.(54) , (55) Applications ofspiritual and religious techniques to the PDs hasso far been limited to just handful of the disorders(for example, borderline, narcissistic, schizotypal,and antisocial). The utility of the numinous fortreating the others still needs to be researched. Theremaining part of this chapter will overview someof the clinical issues related to select PDs.7.1. Schizotypal PDPerhaps one of the central issues in managingpatients with apparent religious delusions orideas of reference is to accurately discern whetherthese “disturbances” reflect cognitive distortionsor real mystical/spiritual experiences. This isparticularly critical when dealing with individualsfrom non-Western cultures, where more animisticreligious beliefs and rituals that involve“spirits” and “demons” exist. To the untrained